Social workers telehealth reimbursement parity is essential for the future / public information service


AUGUSTA, Maine – The pandemic has exposed the benefits of telemedicine – but advocates fear some providers in Maine may not be able to offer it in the long term.

While insurance companies are required to cover telehealth, providers are not always reimbursed at the same rates as for in-person care.

Lynn Stanley, executive director of the Maine chapter of the National Association of Social Workers, said lower reimbursements could prevent providers from offering telehealth – although this has become essential for many people facing a lack of health. child care, transportation or other limiting factors.

“We are concerned that mental health care providers cannot afford to provide telehealth services to their clients,” Stanley said. “If insurance companies lower the reimbursement rate when a service is provided by telehealth, it becomes financially unsustainable for the therapist or agency.”

Some states, like neighboring New Hampshire, have laws requiring insurers to cover telehealth at the same rates, but Stanley noted that Maine is not one of them. And even in reimbursement parity states, the requirement does not apply to self-insured health plans offered at many companies.

Richard Cantz is the CEO of Goodwill Northern New England, which offers self-insured health plans and chooses to reimburse telehealth services at the same rates as in-person care.

He said it increases accessibility – especially in a state like Maine, where over 60% of the population lives in rural areas.

“This is particularly important in our rural territory,” Cantz said. “Transportation and other barriers to health care exist. So that really made the decision easier for us. It was so important, both for accessibility and fairness, to our employees and those we serve. “

He added that others may not have time to take time off work.

Reimbursement parity advocates urge other companies to also cover telehealth at the same rate if they offer self-insurance plans.

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